Application of RFID technology in medical infusion preparation process
Present situation explanation and issue analysis
At present, the preparation process of injectable drugs is printed out by the pharmacy staff. According to the listed drugs, they are dissolved, mixed or diluted, manually checked one by one, and recorded the dosage of the dispensed drug, fill in the sticker label, and fill in manually The drug preparation and signing receipt and the drug entry and exit inventory cards need to record the time of the drug preparation process for the chemotherapy drugs. The required steps are cumbersome and error-prone.
Therefore, the records of the preparation process of each chemotherapy injection, such as: drug name, dose, completion time of preparation, pharmacist, patient and application time, etc., cannot be effectively obtained from the infusion fluid container labeling connection system for administration in time , Reduced the time limit for pharmacists and nursing staff to check the operation.
Implementation
Confirm verification case
1. Definition of application scope
Initially, the scope of verification for the application of medical infusion solutions covered the preparation of TPN (total intravenous nutrition) and chemotherapy injections. After further communication with the responsible pharmacist, the chemotherapy injection was locked. Because TPNs are mostly prepared solutions at the factory, pharmacists only need to add medicines for special nutritional formulas, and their harm is far less than that of chemotherapy drugs. The chemotherapy drugs have high risk (because it will cause corrosion to human skin), high price, and the modulation process requires highly specialized technical characteristics. Regarding the chemotherapy drugs, they are taken from the identification and identification of the pharmacy department. The pharmacist transfers the drugs to the sterile room of the chemotherapy department, informs the ward delivery staff to collect them, and finally arrives at the nurses to apply for the process in the ward. Retrieve label information, compare and sign, and completely record the dispensing process of syringe medicines, and automatically send warning notices.
2. Feasibility assessment of individual cases
When I just discussed the modulation of chemotherapy infusion with hospital pharmacists, I wanted to use RFID for syringe control, and combined with drug barcodes for drug comparison and confirmation, pharmacists thought it was very necessary, in addition to reducing the proportion of wrong medicines, Implement the actions of medical personnel to follow the standard operating procedures for dispensing and administration. Moreover, the use of RFID to automatically retrieve label data automatically completes the use of medicines and syringe modulation registration operations, which can save a lot of manual filling and signing operations.
3. Executive architecture
The verification team first communicated with the relevant department in charge of the Department of Health (Science and Technology Development Group, Hospital Management Committee), and selected the Taichung Hospital as the main test unit for use. After an operator briefing meeting was held in May to explain the contents of the verification, the 9 parties were willing The participating companies (5 RFID hardware, 3 software, and a testing center) work together to carry out proof-of-concept tests for medical infusion RFID applications. The empirical test execution structure is as follows:
Analysis and verification requirements
1. Verification situation analysis
The process of medical infusion RFID application operation is mainly divided into three stages: preparation stage, deployment stage, and notification distribution.
2. Confirmation of verification requirements
(1) This verification is mainly aimed at the red bag of the syringe for the chemotherapy and the syringe of the device. It tests the reading rate of various RFID products, clarifies the technical doubts, and tests whether the syringe contains liquid, which may interfere with the reading. effect. Because the chemotherapeutic drugs are corrosive, the actual drug cannot be used in the verification process, and it is replaced with physiological saline.
(2) Limited by the narrow space of the chemotherapy deployment room, the choice is to focus on the reader with the antenna built into the reading device and the small RFID printer.
(3) Because medicines have not been attached with RFID tags or even barcodes, this proof of concept first plans to use the medicine bottle barcode labels, combined with RFID employee ID cards and patient RFID bracelets, to discuss the integration of barcodes and RFID The application and verification system is mainly used to establish the system for the use of syringes required by patients for chemotherapy, to fully record the modulation status of the syringes and send warning messages in real time.
3. Preparation of verification indicators
When selecting a suitable tag and reader for this proof of concept, the following verification indicators need to be achieved:
(1) The time for signing the dispensing form is shortened from 2 minutes / piece manually filled to 0.2 minutes / piece automatic induction
(2) The efficiency of enquiry and verification of nursing staff was shortened from 3 minutes / piece to 0.5 minutes / piece
(3) Notification notification changed from pharmacist telephone notification to system automatic notification
(4) When reading a single tag, it can be identified 100%
Implementation verification prototype
The first stage of basic performance test
In the first stage, a total of 6 kinds of HF sticker labels, 5 kinds of brands, a total of 7 readers (3 models with USB interface, 2 models using Bluetooth transmission, 1 model for PDA, and the above reader antennas are built-in, The other is an RS232 / Ethernet interface, and the antenna is external). The key conclusions are as follows:
When the standard ISO label is attached to the syringe, the larger the label surface, the greater the reduction in the sensing distance, which is about 15-50%.
The size of the built-in induction antenna of the readers currently tested is not very large (mostly the standard ISO card size, or even smaller), so it is less suitable for reading multiple tags at a time.
The physiological saline used in the test does not affect the RFID sensing distance.
The plastic light shielding bag will not affect the induction of the RFID tag outside the bag even if the syringe is inside.
When receiving the infusion medicine, an external flat antenna (approximately A4 size) is used. The standard ISO card size label can be sensed up to 30cm away, so it can be used to sense multiple light-shielding bags.
Small labels have poor adhesion (perhaps because the curved surface of the 3cc syringe barrel is too curved or the label material is too hard). After standing for a period of time, the label will curl up and the syringe will separate.
Second-stage situational testing
(1) Situational testing
The situation test is to use the label to read the test on the conveyor belt at different moving speeds, simulating the situation where the pharmacist or nurse reads the syringe or the red bag inductively. The important findings are as follows:
The sensing distance of the tag in the moving state is generally shorter than the sensing distance under static. The faster the movement speed, the shorter the sensing distance.
One of the readers (using Bluetooth to transfer data) can dynamically detect the label and emit a "beep" sound during dynamic testing, but the test software cannot display the label ID, indicating that the data transmission cycle takes a long time. Therefore, If this reader is used to read tags, it is recommended to put the identification item in front of the reader, confirm the ID display, and then perform the next reading.
(2) Verification system
Simultaneously with the second phase of situational testing, an infusion RFID verification system was also developed, which completed a total of six subsystems, including:
1. Medication confirmation operation;
2. Chemotherapy RFID label printing operation;
3. Drug matching confirmation operation;
4. Syringe bagging operation;
5. Notify the use of distribution operations;
6. Drug administration in the ward.
The system functions are briefly described as follows:
A. Personnel authority verification
According to the personnel operation authority, the RFID employee card is used to log in to the system and enter the corresponding system screen.
B. RFID tag read-write printing
According to the HIS verification system, the amount of syringes used to modulate the medicine is generated, and the RFID label sticker is generated by the ZebraR2844-ZRFID label printer. The clear code of the RFID tag contains the name of the medicine, the total dose, the syringe serial number / total number of syringes, the medical record number, and the date of adjustment.
The clear code of the RFID tag contains the name of the medicine, the total dose, the syringe serial number / total number of syringes, the medical record number, and the date of adjustment.
When the pharmacist completes the preparation of each syringe, the syringe RFID tag is sensed and confirmed. At this time, the preparation completion time (system time) is written in the RFID tag.
Read the syringe RFID tag before placing the syringe in a light-proof bag (red bag) and check with the red bag RFID tag.
C. RFID drug delivery
The storage area antenna senses the light-proof bag RFID tag, and automatically sends a short message to notify the staff of the corresponding ward nursing station to collect the work.
Pharmacy delivery personnel or nurses using Shida use RFID employee card to detect, record employee code and use time on RFID tag and HIS system.
D. RFID system warning
The pharmacist uses the barcode scanner to scan the bar code of the outer box and check it with the drug project of the HIS system. If it does not match, immediate warning is required.
After the pharmacist completes the preparation, the red bag is placed in the storage area, the RFID antenna senses the RFID tag, and the system immediately informs the nursing station to send the personnel to display the completion of the adjustment message.
The pharmacist or nurse can check the drug items, dosage, patient, and expiration date by scanning the RFID tag and the system. If they do not match, immediate warning is required.
The pharmacist reads and checks before using the medicine. If the medicine expires, an immediate warning is required.
Nurses can read the RFID tag, and the system can check the role of drugs, precautions, and other health education information.
E. RFID drug delivery
Application process
Personnel log-in: The user uses the RFID employee card to log in to the system.
Receipt verification: Sensing the label message on the red bag, verifying the red bag to be used, if there is a red bag short or the validity period is approaching, an SMS notification will be sent in real time.
Receipt record: After confirming that the red bag is completed without error, write in the recipient information and the date of receipt.
Nursing medication process
Personnel login: Nurses log in to the system with RFID employee card induction.
Medication check: The nurse scans the patient's wrist RFID tag, brings out the required chemotherapy drug information, and then senses each syringe tag to check the medication item.
Clinical health education: nurses can read the RFID tag, click on the medicine to display related functions, precautions, and other health education information.
3. The third stage on-site import test
The on-site introduction test was conducted in the chemotherapy deployment room on the ground floor of the Taichung Hospital (the on-site introduction observation observation was held on 11/18), but was limited by the narrow space of the chemotherapy deployment room. Especially in the operation process in the aseptic room, try not to let the dispensing pharmacist hold the reader to sense the syringe label, but fix the reader on the table, let the syringe come closer and sense the record. For the small screen of UMPC, the originally designed verification system is adjusted to enlarge the font and data fields, so that the operator can easily read important data. When designing the interface, as far as possible, no keyboard is required for input actions, but a screen selection. The way.
conclusion and suggestion
The verification test confirmed that RFID technology has management benefits in the application process of chemotherapy infusion solution (identification of syringe and red bag). In addition to integrating RFID and barcode technology, as a staged solution, it simplifies the manual and paper record processing mode and reduces the risk of negligence. In the standard process of checking and dispensing infusion solution, by sending real-time warnings, the probability of medication errors can be reduced; and the management of infusion solution operation and receipt can be strengthened to improve the operation efficiency; in addition, it can be linked with the graphic database of medicines The medication is correct and strengthens the energy of health education consultation. It is limited to manpower and material resources. This proof of concept is only for technical feasibility and preliminary benefit discussion. In the future, it is still necessary to develop and test RFID tags that can be recycled and reused. In terms of external antennas, domestic manufacturers still need to design. To produce antennas with excellent reading performance and stability; hardware manufacturers can also strengthen existing barcode and RFID integrated reading equipment to provide more complete and high-performance solutions.
Wireless Earbuds
True wireless headphones refer to Bluetooth earbuds or IEMs that have neither cords or wires between them nor to an audio source (smartphones, MP3 players, tablet, etc.). Since they have no wires, the mic, controls and battery are built into the housing of the earbuds.Wireless earbuds are great for exercising or listening to music without those pesky cables connecting each earbud. They're ideal for people who need to move about and don't want any cables at all. The drawback is battery life and fit.
Best Earbuds for Gaming,In Ear Bluetooth Headphones,Best Earbuds for Iphone,Truly Wireless Earbuds
Pogo Technology International Ltd , https://www.pogomedical.com